Posts tagged with VETERANS

Since coming back from Afghanistan in 2008, the hard-hit Second Battalion, Seventh Marine Regiment has struggled to adjust. The battalion, known as the 2/7, lost 20 men in war. In the years since, it has lost 13 more to suicide. The battalion now has a suicide rate 14 times that for all Americans.

The New York Times asked Dr. Charles Engel, of the RAND Corporation, and two Marines who served with the battalion in Afghanistan, Arthur Karell and Keith Branch, to answer readers’ questions about the devastating effects of combat and the high suicide rate among veterans. The conversation took place on Facebook in October, moderated by Dave Philipps, a reporter for The Times who covers veterans’ affairs. Here are some of the questions and answers, which have been condensed and edited.

Q. Why were the mental health concerns of the battalion not identified following deployment? What can be done to better identify service members who are struggling?

Arthur Karell: The process for identifying mental health concerns consisted of one post-deployment health assessment (a questionnaire), along with two weeks of downtime leave after getting back to the States. Then the battalion immediately enters a training cycle for the next deployment. The overwhelming emphasis is on constant tactical training — longer-term considerations got crowded out. I have heard that this is now starting to change, and I hope that is actually the case. Allowing Marines and other service members more time to spend together as a cohesive unit after a combat deployment would go a long way to better identifying service members who are struggling. Finally, that there is zero information-sharing between the Department of Defense and the Veterans Administration makes it impossible for health providers or volunteer organizations to have access to information that could provide indications of possible problems. Privacy is an issue, but service members should at least have the option to allow their D.O.D. service records to inform V.A. health providers.

Keith Branch: Ideally, if someone scored as “high risk” on the post-deployment assessment, he or she would be referred to on-base mental health services. From my memory, there were only a handful of service members who utilized these services — I was one of them. However, my stint in therapy lasted less than a month. First, there is an extremely prevalent negative stigma associated with seeking mental health services, especially in the combat arms occupations where weakness is not tolerated. I hope things have changed since 2009. Second, the mental health services on base had long waiting periods and the solution was to prescribe medication. I know more than a few Marines who became addicts while seeking mental health services. From my experience, many Marines do not show signs of mental health problems until they separate from the service. I think being surrounded by the people who served in combat with you provides a sense of security. However, that security is lost when service members separate and return home.

Q.Are multiple combat deployments a contributing factor to suicide?

Dave Philipps: The data suggest there is little or no added suicide risk associated with multiple deployments, but those studies have been unable to address the amount of combat seen. Second, no study has looked at this question after active duty. We simply don’t know. Anecdotally, nine of 13 members of the 2/7 who killed themselves did multiple tours. And I think it is important to note the quick succession of these tours, with less than a year between.

Q.Is the pain experienced by veterans who return from combat rooted primarily in the events of the past or in their outlook for the future?

K.B.: For myself and many other veterans from Second Battalion, Seventh Marines, the pain that is rooted in the past gives rise to an irrational outlook for the future. That is to say, an emotional trigger in the present can provoke the anxiety experienced in a past event and cause a veteran to have an irrational, grim view of the future. Being the tip of the spear for your country instills the highest amount of purpose one could seek to achieve in a lifetime, at least from a veteran’s perspective. The veterans who soon establish a purpose, whether through a career, volunteer work or some other activity, and have a supportive environment, tend to become happy and successful. On the other hand, if a purpose is not found during the critical period of military to civilian transition, veterans will suspend themselves in time. This can lead to many devastating behaviors such as addiction, isolation, and the list goes on. There are other important secondary factors such as the health of intimate relationships, financial stability and treatment from society.

A.K.: The events of the past inform the outlook for the future. When the events of the past repeatedly trigger an anguish that doesn’t abate, it may cause a veteran to question what kind of future they have in store. I’ve heard of post-combat stress described as a response to deep moral trauma, as war is just about the most intense and certainly the largest-scale moral trauma humans inflict on one another. For veterans, post-military activities, pursuits and/or careers that involve or embody a shared purpose, go a long way toward recovery from that moral trauma.

Q.What role do guns have in veterans’ suicides?

D.P.: In the 2/7, nine of the 13 Marines who killed themselves used guns. I spoke to three more who put a gun to their head and pulled the trigger but did not die, and several more who had contemplated suicide with a gun. It appears to be a very big risk factor to have a gun in the house. The V.A. has recognized this, but has been careful in how it presents advice (recommending storing weapons voluntarily with a friend) because doctors don’t want veterans to avoid treatment out of fear they will lose their guns.

Dr. Charles Engel: Six of 10 gun-related deaths are suicides, and about half of all suicides are gun-related. Most suicides occur on impulse, and the availability of a gun makes it all too easy for a person experiencing suicidal thoughts to act on that impulse. Some have speculated that perhaps one reason that suicide is elevated among military personnel and veterans is their experience with guns. Exchanging hostile fire in battle, especially the experience of killing, may represent an important psychological threshold. The tragic psychological familiarity that comes with crossing that threshold may well increase the likelihood of subsequent self-inflicted injury in someone already thinking about suicide.

Q.I know so many veterans who are prescribed all sorts of prescriptions off label and leave the V.A. with a plastic bag full of drugs. Do we know whether these drugs have an effect on the suicide rate?

C.E.: Unfortunately, determining whether there is a causal link between multiple medications and suicide is extremely difficult. The bag of pills observation is all too common in my clinical experience and never a good thing. It’s essential that any person taking prescription psychoactive medication only does so while under the close care of an appropriately credentialed and skilled clinician. Leftover medications and old pill bottles should be disposed of completely to prevent confusion. Less is often more when it comes to the benefits of medications — more medications leads to increased chance of side effects, drug-drug interactions, and mistakes — both by patients when taking them and clinicians when prescribing them. It’s always best to have a primary care clinician who leads the treatment team who can review and oversee your entire treatment regimen.

Q.The public generally uses post-traumatic stress disorder, or PTSD, as a catchall label for the psychological effects of combat. Are there distinct treatments for other issues — guilt, depression, loss of interest in life — that seem to fall outside the clinical definition of PTSD?

C.E.: PTSD, as used among mental health professionals, is a clearly defined constellation of persistent symptoms that is serious enough and lasts long enough to result in significant problems for the person suffering from them. The traumatic psychological events that can result in PTSD go well beyond military-related trauma and can include, for example, accidents, natural disasters, child abuse, and physical and sexual assault. Similarly, the downstream effects of PTSD can be broad and include a range of mental and physical health effects that fall outside the technical definition of the disorder. The most common of these include depression, anxiety, alcohol and drug misuse, chronic pain and sometimes poorly explained but disabling physical symptoms. There are evidence-based treatments for these problems. Those treatments can sometimes overlap with the treatments for PTSD, but combining treatments to target each person’s unique circumstances and health profile is essential.

Q.Why isn’t more being done to try and understand the connection between drug and alcohol use and PTSD?

D.P.: In my reporting on the 2/7 battalion, I found alcohol was a huge factor in a number of deaths. Many of the guys were treating their anxiety and sleep problems with alcohol, which generally created more problems (eroding their support system of loved ones, for example.) At least five of the 13 Marines I wrote about shot themselves while drunk.

Q.Why doesn’t the V.A. track suicides by unit and command? Wouldn’t that tell us a lot about conditions inside those units and who might be in danger?

D.P.: For generations, the V.A. has for the most part attempted to look at all veterans the same regardless of rank or service. This was done altruistically in an attempt to provide veterans the same standard of care. Now, however, health care increasingly uses Big Data to do risk prediction. So all the factors of military service may be extremely helpful in predicting who, for example, is most likely to kill themselves, and what patterns or clusters are emerging. A system that combined military and V.A. data could conceivably spot a combat unit with a high level of mental health issues and target it for outreach. It could also inform policy makers about who is at risk and when, so resources could be designed to meet actual needs. However, the military and V.A. still have a bureaucratic gulf between them that neither is likely bridge alone.

Q. The figure coming from the V.A.: “22 veteran suicides every day” is said to be misleading. Why?

D.P.: The statistic was offered by the V.A. in one of their recent suicide reports. While it seems to be a staggering number, it is actually misleading because it doesn’t tell us the rate as compared to the larger population, so we don’t know if the rate is elevated, and what the trend is. A couple more helpful numbers: The suicide rate for all veterans who served between 2001 and 2009 is about 30 deaths per 100,000 — more than twice the national average. And the risk for them is greatest in the first three years after separating from the military.

Q. With the increased involvement of women in the military, how do their suicide numbers compare with those of men?

C.E. In the military as in the general population, rates of suicide are consistently higher in men than women. However, research suggests that currently deployed women may have higher rates of suicide than military women who have never deployed. In contrast, currently deployed men show little if any increased suicide risk compared to military men who have never deployed. An Army study found that the risk of suicide among currently deployed women was about three times that of nondeployed women. Even so, the risk of suicide among currently deployed men was still almost twice as high as for currently deployed women.

D.P.: In general, women have much lower rates of suicide than men, in part because men tend to use firearms more often. But a recent study found women who are veterans are drastically more likely to commit suicide than civilian women. This may be because women who are veterans use firearms more often.

As suicide attempts go, mine was of the halfhearted variety. In fact, some might even argue that it was no attempt at all. The police arrived at my Austin home following a fight I’d had in the driveway with my friend Bill, who’s also a veteran. Bill had been called over to the house by my then girlfriend because she was worried about the way I was acting.

I was wired on a cocktail of Adderall and Trazodone, and had a few drinks the night before as well. When the police arrived the following morning, a man and a woman, I asked the woman if her pistol was loaded.

“Of course it is. Why would you ask a thing like that?”

“Because I want you to shoot me in the head.”

To this day, I’m not sure why I said that. In retrospect I think it was less about wanting to die and more about expressing to another human being that I was in pain. But they were police officers, and a solicitation for suicide-by-cop, however unconvincing, was something they took very seriously.

“Right,” the male officer interjected. “We’re gonna have to bring you to the hospital.”

A minor struggle ensued outside, to the entertainment of my neighbors who observed the scene from a comfortable distance. I learned later from Bill and my now ex-girlfriend that the police entered my home and grabbed all the pharmacy bottles they could find (which numbered in the teens) and brought them to the hospital so the emergency room staff would know what I was on. They even stuck a catheter up my urethra.

They held me in observation for a day and a half, until I could get a friend to pick me up and drive me to the Austin Veterans Affairs Outpatient Clinic to speak to a mental health specialist. She wanted me to come in every week through the summer, but I told her I had plans to study abroad in France, so she made me promise to check back in when I returned or she would have me brought in. I came for a follow-up at the end of the summer, just because I didn’t want the police to come back to my house. I had no interest in engaging with the V.A. mental health specialists. They were way too quick to prescribe medication, and drugs were something I was trying to get away from.

In Afghanistan, I served as a Navy corpsman (combat medic). I never fired a weapon in combat, but I did treat gunshot and fragmentation wounds. The heat, the sweat, the smell of filth, the fear and danger, the long hours on the road, the mutual distrust of the local populace, the belief that the next time we left the wire would be the time we’d get hit, the four or five instances of absolute terror spread out over a yearlong deployment – these were the things that gave me pause and caused me to desire and seek numbness.

I had also suffered an injury in a car accident a year before I got out of the Navy. The accident was caused by an adverse reaction to a sleep medication, which led me to sleepwalk to my car, get in and drive. As a result, there was no shortage of pain medications in my possession.

For a person in free fall, it’s difficult to see the bottom. Certain programs of recovery describe a “white light” experience; a moment of divine clarity in which the user finally gets it. This was not true for me. I’d tried in vain to get clean for the better part of four years following my return from Afghanistan. Eventually, the effort paid off, and I got better. There was no white light.

It requires great discipline to get sober and stay sober. But sobriety also requires community. It’s necessary to be able to say to another addict or alcoholic, “I have this problem, too; I’m like you. If I can beat this, you can beat this.”

Veterans with drinking and drug problems experience an additional layer of isolation. The feeling that we can’t relate to non-veteran addicts and alcoholics is pervasive among the veterans in recovery whom I know personally. But I’ve come to learn that addiction is indiscriminate, and we have more in common with civilian addicts than we’re perhaps inclined to believe.

We can’t talk sensibly about veteran suicide without first talking seriously about veteran addiction. Drug and alcohol abuse are major indicators of suicide. This is especially true in the veterans community. There’s no doubt that we’re facing a mental health crisis. Our mental health professionals in the V.A. and in the civilian world have a tendency to over prescribe mood stabilizers, tranquilizers and anti-depressants. These drugs all have legitimate uses, and many patients absolutely need them. But if our focus is on using drugs to treat post-traumatic stress disorder or other combat related problems, we might, in fact, be making things worse. It’s possible that I’m wrong; I speak entirely from my own experience. But for me, I could not come down off the ledge until the drugs and alcohol were off the table.

Brandon Caro is the author of the debut novel, Old Silk Road (Post Hill Press, Oct. 13, 2015). He was a Navy corpsman (combat medic) and adviser to the Afghan National Army in Afghanistan from 2006-7. He holds a bachelor’s degree in liberal arts from Texas State University, and is currently pursuing a master’s degree in fiction writing from The New School in New York City.

A month before I started my freshman year of high school, my father was killed in a cycling accident. Overnight my mother became a single parent and our sole breadwinner. She was forced to work twelve-hour days to maintain our standard of living and consequently I was often alone in an empty house.

Like most teenagers, I rebelled. With the loss of my father came a profound loss of discipline in my life. Combined with the sudden absence of my mother who was now compelled to work long hours, the tragedy had an important tertiary effect: I stopped attending classes. Eventually, to the distress of my mother, I left high school, opting to take the G.E.D. instead. College was the last thing on my mind, because college was for savvy, affluent students who studied for SATs and graduated on a normal schedule. It wasn’t for people like me.

At 17, I would have been the ideal candidate for an ‘absentee father’ case study: misguided anger, unabashed recklessness, unclear identity. I sought challenges but had no purpose. Luckily (or unluckily) for me there was a war.

I was an Army recruiter’s dream. With my mother’s anxious signature, I was in.

Throughout most of my seven years in the military I gave little thought to the outside world. When provided the discipline, direction, and the brutish encouragement of male authority figures, I began to excel, rapidly advancing through the ranks. I was given ever-greater responsibility — making sergeant in two years. After my first three-year contract expired I enthusiastically re-enlisted for another four.

One of our missions was to facilitate the opening of schools in Kunduz Province. That April, in an effort to intimidate girls from attending, the Taliban attacked the schools with poison gas. It didn’t work. The girls continued to walk to class despite the threat.

As a teenager, I had taken for granted the opportunity to have an education not because an armed insurgency prevented me, but because of my own ambivalence. In Afghanistan, a country plagued with incessant violence, the decision to go to school was often one of life or death. For me, it was a luxury I had wasted. And I regretted it.

A switch had been flipped. For the rest of my deployment nothing could satisfy my thirst for knowledge. I began ordering books online and borrowing from fellow soldiers: politics, literature, science, mathematics — anything and everything. The inevitable downtime that accompanies the soldier’s profession proved ideal for reading. As my squad hovered around a laptop watching bootleg copies of “The Jersey Shore,” I found myself reducing fractions, reading Steinbeck and keeping up on the midterm congressional elections.

One night after a long political conversation with my company commander, he looked at me meaningfully and asked, “Why don’t you go to college?”

Hearing those words out loud was the catalyst I needed. Though the Army had been my home for seven years, and these men were my family, I had been quietly realizing that the path I was seeking was not one I could find in the military.

A year later, I was out. I moved to Chicago and enrolled in a local community college.

I walked into my first class convinced that what felt so inconceivable as a teenager would now be a breeze. I had matured in the military, instilled with discipline, commitment and leadership skills. I’d be the exemplary student. After all, I used to get shot at for a living. How hard could it be?

Turns out, really hard.

I had spent months preparing for the academic rigor, but what I could not have anticipated was the challenge of reintegrating into society. I never expected college to be more stressful than combat. But it was, only different: almost entirely self-inflicted. I was consumed by the fear that no matter what I did, I would never be able to relate to my classmates. I was older, had fought in two wars and been exposed to death. What could we possibly have in common?

I bore scores of prejudices from the military to my civilian life. They were part of my identity, making it impossible to connect with anyone, impossible to make friends, impossible to reintegrate.

It was difficult to adjust to the loss of camaraderie and trust that I took for granted in the military. The culture of an infantry platoon resembles that of a tribe, into which one is indoctrinated only by the mystery of violence and death. Outsiders uninitiated into this mystery are regarded with suspicion. In combat, I knew whom I could trust — the members of my tribe. For years I trained, ate, slept and fought with the same men. It forged an incredible bond and a sense of safety. Paradoxically, I felt more secure in Iraq and Afghanistan than anywhere else.

In an effort to find solace I joined my university’s Student Veterans of America chapter where I found a community of people who had gone through similar situations. I joined a writing group for veterans where I could put painful memories into a narrative that I could control. As productive as this was, however, I was still segregating myself from my civilian peers. That I still regarded them as “civilians” told how much I still viewed myself as an outsider. I had formed nearly no relationships with my fellow non-veteran classmates.

I hated the questions I feared they would ask: “So, why did you join the military?” To me, this was a ridiculous query. There was a war. Why didn’t you join?

I became more resentful, withdrawn. In terms of distance from my classmates, I felt as if I was from Mars.

My animosity turned into untenable opinions. Those who didn’t serve became “selfish” or “cowards,” unworthy of my respect. I thought: “Who were they to think they had something better to do while those, like me, were fighting and dying on their behalf.”

Then, my sophomore year, I met a girl in biology class who had been battling leukemia almost her entire life — and was now studying oncology nursing. Having spent most of her life inside a hospital, she wanted to provide comfort and empathy to others afflicted with the same disease. She didn’t seem to bear any resentment or animosity. I came to view her bravery with admiration. I wasn’t the only one who’d suffered.

Once again, like in Afghanistan, I felt ashamed of my actions. I realized that it was only my own self-prescribed prejudices that were holding me back. When I accepted others for who they were, when I began listening to their stories, I learned that everyone fights their own wars. Making friends became easier. As it turns out, reintegration is a two-way street.

After spending a year at that community college in suburban Chicago, I transferred as a junior to the American University of Paris. I’m now finishing my last semester there and, like most soon-to-be graduates, I find myself thoroughly occupied. I petition companies for unpaid internships, procrastinate on my thesis and remain in a constant state of near-panic at the prospect of moving back in with my mother.

I know that I made the right decision; the benefits of a four-year degree are backed by indisputable empirical evidence. But there’s more to college than just increasing the chances of professional success. The four years have also represented a long and important process by which I’ve re-entered civilian life. It was a place where my intellectual hunger could feast, and most importantly — I found my passion.

Sadly, too many of my fellow veterans are not taking advantage of this opportunity. Only about half of the eligible veterans use their Post-9/11 G.I. Bill benefits, which cover tuition, living expenses and even books. Moreover, a recent study showed that only half of those who do return to school are graduating – which means only a quarter of eligible veterans are earning college degrees. This golden opportunity is being wasted.

I don’t presume to know all the reasons student veterans decide to leave college, or never enroll in the first place. Some probably found lucrative employment as contractors overseas, or in the oil industry. Many have unique obstacles that “traditional” students typically do not, such as families or physical and mental trauma. But with unemployment rates among veterans aged 18 to 25 at 7 percent (national average is 5.1 percent) the issue is disconcerting.

I’ll spare readers the “If I can do it, anyone can” cliché. But, for many of my fellow veterans college may not just be a place for learning, but also for healing. It was for me.
Ryan Blum was a squad leader with the Army’s 10th Mountain Division, deploying twice to Iraq and once to Afghanistan. He now studies International Affairs at the American University of Paris. He is also a member of Foreign Policy’s Best Defense Council of the Former Enlisted which seeks to inject more of the enlisted perspective into policy discussions. Twitter: @ryanblum1

My wedding day was the first best day of my life. I could not have ordered a more perfect day if I had had a menu of choices in front of me. The marriage to my best friend was what I was really looking forward to. I wanted to settle down and start a family and that’s what we did. Our ideal world was lost on Sept. 6th, 2003. My husband, a member of the National Guard, was activated two days before our second son was born. Two weeks later he went to Iraq on what ended up being almost a year-and-a-half journey where he fought for his country and I fought to maintain our home.

For years after his deployment, I watched him struggle. I scratched and clawed to get him resources that were difficult to coordinate. I begged for tests; I fought to be the voice he did not have; I fought to be heard. He would tell his health-care providers one thing, but I would witness another. They experimented with a string of antipsychotic drugs, leaving me to deal with the potential dangerous side effects without any heads up. I put up with way more than I should have, but I held tight to our “for better or worse” vows and the unbending belief that if the tables were turned he would do the same for me. He would take care of me, right? After years of working through the system, we finally got the diagnoses of traumatic brain injury (TBI) on top of post-traumatic stress disorder. His care team fought hard to make sure his needs were met. We even started a nonprofit geared toward helping veterans and their families.

As time went by, two more babies came. My husband had moments of happiness, but generally was deep in depression, struggling with severe migraines and issues with TBI. Suffice it to say that certain lines were crossed, and I felt I could no longer remain married to him. I asked him to leave and, on Friday, our divorce became final. He let me go without hesitation. For him, there was apparently no reason to fight to keep me. I don’t want to come across as a bitter ex-wife. But I am angry that our happy life, our loving relationship was destroyed in combat.

After all I had been through with him, I was now faced with another reality. Once you are divorced from a veteran, resources such as counseling go away. I even asked for help to tell him to leave the house but was told no, even though I worried for my safety. I was told their services were to provide a safe place for the veteran.

After all the hard work, devotion and advocacy, I felt demoted, unloved.

Veterans need to learn how to reintegrate into their families and how to take care of those families again; how to trust their spouses again. As a caregiver, you are put in a position of authority over your spouse, doling out daily “what to do’s,” managing the finances. What toll does that take on a marriage that is supposed to be built on equal partnership? At the same time, the caregiver feels forgotten, berated and belittled because his or her complaints pale in comparison to the pain, emotional or otherwise, of the veteran. What happens when we get sick? Surely we do not want to be told, as some spouses are, “It’s not like you’re dying! I know guys whose legs have been blown off.”

As it turns out, I am lucky. I have a job with benefits. But there are so many other military spouses who gave up careers and education to take care of their wounded partners, only to see their marriages disintegrate and find themselves emotionally devastated and without money. At that point, they no longer have access to the multitude of resources available to veterans and their families, such as Department of Veterans Affairs individual or group counseling or educational benefits. Many women who were dependent on their spouses’ incomes also find themselves financially in shambles after divorce. Such women, unless they were fiduciaries of their husbands’ veterans benefits, might have no access to that money during, or after, marriage.

So, now I am asking myself, what are those spouses supposed to do when they too serve their country and work so hard to help veterans and their families, but are not eligible for their services anymore because they are not family anymore. Many of us feel angry, like we were left holding the empty bag. I really wanted what my parents had, that 50 years together, growing old together thing. I wanted to be worth fighting for, too.

Jackie McMichael is from Durham, N.C., where she currently works as a professional development manager in the software industry. She was married for 15 years to an officer in the North Carolina National Guard and currently works in her spare time with veteran spouses and organizations.

Leah Pfeiffer, left, a student at the Culinary Institute of America, and Chuck Yu, a West Point cadet, cooking in a C.I.A. kitchen in October 2013.Credit Mike Groll for The New York Times

We are hard pressed to think of many world-class liberal arts colleges with entire student bodies ambitiously studying and training toward a single profession – and in uniforms that are far from Vassar’s or Columbia’s baseball caps or yoga pants. While the Culinary Institute of America prepares its student chefs for successful careers in hospitality, just across the Hudson River, the United States Military Academy at West Point’s mission is to “educate, train and inspire” its own student body for the profession of arms. The two institutions seem worlds apart, yet conversations over a couple of meals quickly demonstrate otherwise.

Most readers will be familiar with West Point’s role in American history, dating back to when George Washington, as a general, recognized the strategic importance of the real estate perched on the west bank of the Hudson River. Its neighbor is similarly steeped in military history. Despite no small amount of Capitol Hill gridlock, Congress passed the Servicemen’s Readjustment Act of 1944, known as the G.I. Bill of Rights, to support veterans’ transitions into civilian life. Frances Roth, a lawyer, and Katharine Angell, the wife of James Rowland Angell, then the president of Yale, created the New Haven Restaurant Institute, the “culinary center of the nation,” with the mission to retrain returning World War II veterans for postwar livelihoods.

Within four years of opening its doors in 1946, 600 veterans from 38 states had graduated from the institute, and Eleanor Roosevelt, the former first lady and a supportive neighbor at Hyde Park, even helped settle the debate about whether “culinary” should be pronounced “CULL-in-air-ee” or “COO-lin-air-ee.” (The former won out.) In 1970, the Culinary Institute of America purchased the St. Andrew-on-Hudson Jesuit novitiate and moved the school from Connecticut to its current “rockbound highland home” in New York.

A mere 50 years ago, Americans would have known veterans and heard their stories. At the peak of World War II, just shy of 10 percent of the population was serving in the military. Today about 0.5 percent of the population serves in the armed forces. With such contrast between then and now, it is little wonder that young people have scarce knowledge of or experience with those in uniform, even with the recent conflicts in Iraq and Afghanistan.

The gaps in historical memory and civil-military understanding cut both ways. Despite the schools’ proximity, today’s era of celebrity chefs and the Food Network means West Pointers are better equipped to name the Culinary Institute of America graduates Anthony Bourdain and Duff Goldman than to recount their neighbor’s rich military history. Cadets certainly know what awaits when opening a can of Chef Boyardee, but few can recall that Ettore Boiardi’s company was commissioned to operate around the clock to feed American soldiers during World War II. And when we mention our partnership with the C.I.A., our Army colleagues quickly assume we are referring to spooks, not chefs.

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Claudia Fox, left, a student at the Culinary Institute of America, was given a tour of the West Point campus in September 2013 by Cadet Oriana Ellis.Credit Phil Mansfield for The New York Times

In 2012, the West Point professors Brian and Terry Babcock-Lumish met Rich Vergili, a C.I.A. faculty member, at a Slow Food Hudson Valley event. While picking organic strawberries at Thompson-Finch Farm, the three found themselves comparing teaching experiences at their respective schools, and imagined the conversations their students might have if given the opportunity.

Since then, the two institutions have grown closer, and in doing so, are reclaiming their common history. An initiative started on the anniversary of the Sept. 11 attacks, the “day in the life” exchange, is now an established program each fall and spring semester, during which 10 competitively selected West Point cadets are paired with 10 student chefs to take turns spending the day on one another’s turf.

When hosting in Hyde Park, the student chefs quickly put the West Pointers, sporting iconic chef’s whites and toques, to work in the bustling kitchens of Roth Hall, uniformly cubing carrots and dicing potatoes. For cadets without access to kitchen facilities and limited to one regulated appliance in cramped barracks rooms, even holding a knife properly can be a new and dangerous experience.

When the C.I.A. students arrive at the academy, they are immediately launched into a simulation as if they were new cadets reporting for duty. Chefs step up to the academy’s fearsome Cadet in the Red Sash — a tradition of Reception Day — and go on to march in formation, fire simulation weapons and complete obstacle-based workouts.

The point is never to overwhelm or haze, but to immerse. In doing so, future leaders are encouraged to build relationships – challenging assumptions, combating misconception and starting a dialogue – early in their careers.

When it comes to food, many West Pointers are socialized to prioritize quantity over quality. An army may march on its stomach: A bad meal, or no meal, adversely affects everyone. The prospect of stopping, savoring and appreciating complex flavors does not fit neatly into aggressive schedules involving military responsibilities and parade practice on top of problem sets and papers.

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Amy Saxton, left, a West Point cadet, working with April Heckathorn, a student at the Culinary Institute of America, in March 2014 in the C.I.A. kitchens.Credit Phil Mansfield for The New York Times

In contrast, aspiring chefs relish the opportunity to explore the area’s farms, sourcing local ingredients and brainstorming dishes to which they will dedicate hours. While visiting the academy, they find themselves most at home in the bowels of Washington Hall, exploring the spotless kitchen complex – commercial combi ovens and giant Hobart mixers – responsible for producing tremendous quantities of food daily.

Despite initial anxieties, none of these students are strangers to the rigors of basic training. Today’s chefs are steeped in the tradition of Auguste Escoffier, who canonized cooking techniques and recipes, and created the kitchen brigade system that keeps today’s professional kitchens ticking. Cadets and chefs recognize their many parallels: Grace under pressure is essential; attention to detail matters; and a certain obsession with logistics is critical to success, even if manifested differently across the Hudson or throughout one’s career.

When the conversations turn to hopes and concerns for their future, or dating and drinking the following weekend, distinctions quickly blur. Although we collaborate with the C.I.A.’s leaders to convene these initial visits, a successful partnership quickly takes on a life of its own. Armed with Facebook and smartphones, 21-year-olds are 21-year-olds and definitely do not need their professors interfering. This is precisely the point.

Before his retirement after 43 years in uniform, Adm. Mike Mullen, then the chairman of the Joint Chiefs of Staff, addressed the increasing civil-military divide in American society. Reliant upon a leaner, all-volunteer force isolated on fewer military installations after base closures, Americans have less exposure to service members.

At the same time, Gen. Martin E. Dempsey, the current chairman of the Joint Chiefs and a former West Point English instructor, insists that the civil-military dialogue must go both ways: Failure to do so will exacerbate the disconnect between the military and the broader society it serves.

On the civilian side, the State Department’s Diplomatic Culinary Partnership elevates the role of food in America’s public diplomacy efforts abroad. However, one need not be an ambassador to recognize the value of food in bringing people together across borders and boundaries. Most cultures view food as far more than sustenance, but as a textured form of communication, rich with both flavor and meaning.

Understanding not only what one eats but also where it comes from, how it is prepared and who has a seat at the table offers tremendous insight into a community and its priorities. Ultimately, breaking – and making – bread together offers invaluable opportunities to connect cultures and cultivate trust.

Dr. Terry Babcock-Lumish, president of Islay Consulting, taught economics at West Point from 2012 to 2014 and founded the Culinary Institute of America partnership with her husband, Major Brian Babcock-Lumish of the Army. Major Erin Hadlock serves as an Army aviator and currently teaches English at the United States Military Academy. Today, she leads West Point’s exchange efforts with Dr. Ruth Beitler, an anthropologist and director of the academy’s Conflict and Human Security Studies Program.

The opinions expressed do not necessarily represent those of the United States Military Academy, the Department of the Army or the Department of Defense.

This week, the trial of the man accused of killing Chris Kyle opens in a Texas courtroom, even as the Clint Eastwood film based on Mr. Kyle’s life, “American Sniper,” is playing in a theater three miles away. Much as Mr. Kyle’s death shocked the nation, the film has generated fierce debate nationally over the meaning of his life and his death, and the Iraq war itself. To some, Mr. Kyle represents all that was right with the American-led invasion, to others, all that was wrong. Yet to many veterans, his story offers a chance to discuss and debate a remarkable array of complex and personal questions: the mix of motivations that lead people to sign up in the military, the riot of emotions troops feel when they kill or witness death, the struggle to reengage with civilian society upon coming home. A number of people have sent At War essays about how they viewed the film, including the piece below by a former Marine. What do you think? Send us your thoughts: atwar@nytimes.com.

We arrived at the mall and made our way to the massive IMAX theater where we found all but the first few rows completely full. “At least it’ll be immersive,” my wife said with a look of optimism as we took our seats. “Oh great,” I thought to myself, “an immersive experience of the Iraq war, this ought to be good for me.”

While reading “American Sniper” last year, I saw in Chris Kyle a man who had made himself vulnerable in his struggle to become human again while recounting the events that led him to become America’s most deadly sniper. Now with the movie, I thought that perhaps its six Oscar nominations were an effort by the Academy to say, “This subject is important and we should be taking it seriously.” But it also occurred to me that the nominations were just a figurative pat on their own backs for “serving those who served.”

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Douglas W. Jackson in Iraq in 2007, where he served as a rifleman in the Marines.Credit Courtesy of Douglas W. Jackson

I was reminded of “The Hurt Locker,” which had the movie industry convinced that they’d nailed it. “It seemed so realistic,” I can remember some people telling me. Give me a break. And then there was “Zero Dark Thirty” (also based on a Navy SEAL memoir). It, too, received wide critical acclaim with several Oscar and Golden Globe nominations. Perhaps for some audiences it was an entertaining, climactic moment seeing Osama Bin Laden killed on screen. But I couldn’t help but think of a much more pressing narrative: the nation’s involvement in Afghanistan. I mean, why not show any one of the countless Army units living in the mountains for 12 months at a time, being attacked daily and barely making it out alive?

So with tempered expectations, I watched “American Sniper,” thinking, “Maybe this is Hollywood doing the best it can with limited understanding and budget.” But I started to reach my limit, my list of grievances adding up: gaping entrance wounds and digital blood, poor weapon handling, inaccurate military lingo, blinding muzzle flashes at night with suppressors on the end of M-4 carbines.

Then came a surprise: The scenes of Mr. Kyle returning from war. Initially these moments seemed fairly normal — until I realized that this was a calculated attempt to show how not normal it is to come home with a higher state of vigilance, sense of urgency and suspicion of others, all hallmarks of post-traumatic stress disorder. “That,” I thought, “I can relate to.” Multiple firefights and engagements with the enemy continued to play out, some more accurate than others. But as the film drew to a close, I thought, “They may actually get me after all.”

When Hollywood stepped aside and the story that inspired the film, Mr. Kyle’s death — that was the moment I finally felt overwhelmed. My jaw began to tighten, my eyes fixed on the screen and I dreaded the wave of emotions I knew would come next. When the actual footage of his funeral motorcade played out, with pictures of him and his family and simple white on black text that read, “killed while helping a fellow veteran,” only then did I feel I was finally introduced to the real Chris Kyle.

One of the less discussed messages of the film is how the motivation for joining the military is rarely the motivation for staying in, going back to war or doing the actual fighting. Mr. Kyle signed up in response to the 1998 attacks on American embassies in Africa, as many from my generation joined in response to the attacks on Sept. 11, 2001. But by the time I arrived in Iraq in 2007, “victory” had already been declared. I wasn’t there to rid Iraq of Saddam or prevent another 9/11. I was there to answer a question: “Can I endure the most difficult thing a man can face?” I was there for the war experience. Though it may seem noble to fight for one’s country and family, those weren’t my reasons for going to Iraq. So no one is in my debt, no one owes me anything.

But we do owe it to ourselves to understand the wars we have waged and those who have fought them.

We cannot simply thank the troops and then encourage them to go on with their lives. And we veterans do not have the luxury of remaining silent about our experiences. Everyone admires the “Greatest Generation” for their humility and how unlikely they are to talk about their war memories. But there is no shortage of awareness when a country experiences total war, when sugar is rationed and tens of thousands of men are lost in a single day of fighting. Iraq was so incredibly different. During the past decade of war, less than 1 percent of the American population served in the military at any given time, compared with more than 12 percent during World War II.

My guess is that many veterans will look past the inaccuracies of “American Sniper” because, quite frankly, it’s the best thing we’ve got. Cobra attack helicopters flying during a sandstorm, satellite phone calls home during sandstorms and firefights. I don’t think so. Maybe in Hollywood but not in Iraq. The truth is, we can do so much better than this. But the film could play an important role in reminding us of how unresolved this whole chapter of our history really is. We know Iraq had nothing to do with the Sept. 11 attacks, and that Saddam Hussein did not have weapons of mass destruction. Add to that the recent news of the Islamic State now controlling large parts of Iraq and you have got a generation of veterans who bear an incredibly unique burden.

Yet there’s been a lack of meaningful conversation about the Iraq war in general, and “American Sniper” in particular. Either you loved the film, and so are viewed as a war monger by its critics; or you are a critic of the film and branded unpatriotic by its supporters. We would do well to begin separating these debates and recognizing the difference between those who tell war stories on screen and those who were actually there. And even more, remembering that those who send the country to war are often disconnected from the ones who end up fighting. Unfortunately, these conflicts have exhausted or killed some of those most qualified to speak about the costs of war. What hope do we have if we do not seek to engage with those who remain?
Douglas W. Jackson served four years as a rifleman in the Marines, and was deployed to Iraq during the surge of 2007. He is a recent film school graduate based in Florida. See more of his work at jacksondwj.com

Chris Marvin at a panel discussion last month at the National Geographic Society in Washington. Mr. Marvin's organization, Got Your 6, fights stereotypes of military veterans in movies and on television.Credit Gabriella Demczuk for The New York Times

Whenever movies about the wars in Iraq and Afghanistan come up when I’m interviewing veterans, talk inevitably turns to “The Hurt Locker.” Almost everyone who has deployed tells me they found the portrayals of life on an Explosive Ordnance Disposal team in Iraq laughably over the top: Since when do bomb techs ride out into the desert solo in full sniper gear?

But then they bring up “the cereal scene” — where Staff Sgt. William James returns from war and finds himself shopping for groceries. In the cereal aisle, he stares silently at the hundreds of choices, seemingly disconnected and lost in thought, overwhelmed perhaps by the banality of the abundance surrounding him. Without looking, he throws a cereal box into the cart and walks off. A few scenes later, he is back in Iraq, seemingly more at ease.

We published this article today about the push to portray veterans in a more thoughtful, realistic light onscreen. We focused on a retired Army captain, Chris Marvin, the founder of Got Your 6, who is leading the charge. He offered his hits (“American Sniper,” “Lone Survivor,” “The Mindy Project”) and duds (“Brothers,” “Forrest Gump,” “CSI: NY”).

If you’re a veteran, tell us in the comments section what other onscreen portrayals of veterans do you think either captured what it is like to be a veteran after 9/11, or made you cringe?

Pvt. Richard Halvey scribbled his last letter home in the passenger seat of an Army radio vehicle rumbling somewhere through North Africa in February 1943. He wrote on the desk built into the front of the car while his friend Ryan drove, passing across chocolate bars and sticks of gum. He complained about his warts (“I even have an idea they are bringing friends”). He asked after his driver’s license and his brother, Bob. He spoke of regret that he had to shave his mustache without taking a photo first (“Beards aren’t permitted in this company and mustache was starting to strain coffee etc so rather than have it dry cleaned I decided to dispense with it”). The last letter addressed to my grandmother, Patricia, his sister, was just a quick note about a $30 money order, later carefully pressed flat; his mistake in dating the top delicately corrected in Pat’s spindly hand.

He was 23 when he succumbed to his wounds in a Tunisian hospital. The war department sent a Purple Heart to Philadelphia and, later, his body to Virginia.

Death visits on the mundane a heightened gravity, making the trivial beautiful and the everyday weighty. Had Private Halvey lived, had his letter not been followed by a terse telegram reporting his death “of wounds received in action in defense of his country,” that letter might be softly rotting in an airless attic now, or forgotten in an estate sale trunk. He might have grandchildren, kids with blue eyes and long limbs and the borrowed grace of a once and future basketball star. Instead, the letters are stuck together in a scrapbook made by my grandmother, a tribute to her beloved brother. There would be no girl and no wedding band, no sons, no forwarding address.

I first read my great-uncle’s letters in high school, an audience he could never have imagined. Growing up, I’d heard stories and seen a picture of him, posed with a rifle over the mantel. But it wasn’t until I opened the faded green scrapbook that I became fixated on his short life. It was not that he was exceptional, but rather that he was so ordinary: a normal, kind-hearted young man who had marched into a storm set in motion before he was born, at nearly the same age that I am now. On Veterans Day, especially, I think of my grandfathers, both in the Navy and lucky enough to survive the war, and then of Dick Halvey, grinning on his parents’ porch, hand raised in a salute, and I open the scrapbook again. It contains his letters home, his obituaries, condolence cards, high school grades, a map of Arlington.

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Private Harvey's letters in a family scrapbook.Credit Courtesy of Kiley Bense

The early letters, mailed from Camp Wheeler and Camp Meade and now glued to the book’s first pages, described his bunkmates, his meals, the bedroom slippers he wished his mother would send. In one, he wrote about a Harvard man asking him for shoe polish. He described an overnight train ride. Without access to a map, he asked how many days’ journey Macon, Ga., was from home. A few men were mentioned: Ryan, who told him about the street cars in Glasgow; and Joe Shea and Bill Haggerty, who were also from Philadelphia. From North Africa, he wrote about a cactus thorn burrowed in his thumb, making his job as a radio operator painful. If he had lived to see the close of the war, he might have written, too, of the ruins of Italy and the crowded banks at Normandy.

In his high school valedictorian speech for the class of 1936, my great-uncle wrote of the gathering conflict abroad: “Is it strange that peace delays her coming? Where are the men of good will who are to receive her benefactions?” America must abandon its isolationism if peace was what it sincerely wanted, and it was the duty of principled men to act for peace. “Only by producing men of good will can we advance the cause of universal peace.” And so he volunteered, a ready and spirited recruit — a man of good will. His father, Brendan, later wrote of his sons, “I am mighty proud of the two boys; fellows who answered the call the hard way, seeking neither matrimony to dodge it, nor commissions to soften their journey. They went when their time came, took what their Government saw fit to give them and asked no favors.”

The son of a janitor and a writer, Richard Halvey played basketball for Roman Catholic High in Philadelphia (my grandmother became a lifelong basketball fan, although none of her five children were on a team). He borrowed his aunt’s roadster for weekend trips to the Jersey shore. He was popular and handsome and loved to sit up with the fathers of the girls he took out on Saturday nights, drinking whiskey and telling jokes. To my homely grandmother, he was something of a hero.

In the Army, Private Halvey wanted more than anything to drive a vehicle — a truck or tank or car of any kind. But he was assigned to record an endless parade of dots and dashes, tedious work he despised. In Tunisia, he must have been exhausted, existing on canned rations in the rocky, treacherous desert. But he rarely complained, telling his family about serving Mass every morning, wearing a knife and revolver instead of a cassock.

My great-grandfather’s attempts to seek more details about his son’s death and last days were met with refusals from the war department, so all we ever knew was in the few scraps of information sent at the time: that Private Halvey was wounded in action and died a few days later in March 1943, carrying his high school ring. His letters revealed that he was under fire for most of his time in North Africa. He was originally buried in Tunisia; his body was shipped to Arlington after the war.

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The telegram alerting Private Halvey's father of his son's death.Credit Courtesy of Kiley Bense

His absence drew a dark gash through the lives of his family back home: My grandmother’s own youth snapped over his death, and her mother’s a year earlier. My great-grandfather’s grief kept him housebound for months. In the wake of their loss, my grandmother took charge of the household, caring and cooking for her brother and tormented father. It was a responsibility that she forever shouldered, and one that probably kept her from marrying until she was in her 30s, a spinster by the standards of the day. Even after her wedding, Brendan and Bob continued to live with her. She named her first son for the brother she had lost.

Two years ago, I copied the cemetery map in the scrapbook (the route to his headstone traced in red pencil) and took it with me to Arlington. There I found a kind of solace in this place that my grandmother had once visited, bringing her children and now elderly father with her. My dad, at 7 years old, remembered that they watched a nearby funeral procession wind to a stop. Taps played and my grandmother cried. Brendan Halvey, so stoic for much of his life despite all he had endured, cried, too. Bob took a photo of the family clustered around the grave: my dad and his brothers with buzzcuts and ears like open shutters; Brendan in a dark suit and tie despite the summer heat.

My favorite photograph of the three Halvey siblings was taken at the Jersey Shore in the early ’30s. They were 14 or 15, posing with their dad on the beach in Atlantic City. Dick and Bob Halvey, both in belted swim costumes, stand with feet apart, hands on hips, wearing jubilant grins and tousled hair. My grandmother, Pat, wears pigtails and a half-smile next to Dick, her sideways gaze on his face.

Kiley Bense is a recent graduate of Columbia University’s Graduate School of Journalism and the University of Pennsylvania. She currently works as a longform intern at Entertainment Weekly. Her writing has appeared online at Saveur, Real Simple, and Narratively. Follow her on Twitter: @kileybense

No millennial worth his iPhone remembers life before social media. While previous generations’ warfighters wrote letters or phoned home over spotty connections, Marines today can post on Instagram photos of themselves sitting atop cans of ammunition. In 2010, the photojournalist Teru Kuwayama and his collaborators embedded in Afghanistan to start a Facebook page for the First Battalion, Eighth Marines to communicate with loved ones. Far from resulting in just another live-stream of minutiae, their Basetrack project became a way for deployed troops to maintain relationships with their families. The resulting trove of photos and videos provide ample fodder for “Basetrack Live” — the onstage story of one corporal’s deployment and homecoming, and the effects on his family.

For both the battalion and a nation’s artists, self-reflection occurred stunningly quickly through the use of social media. Anne Hamburger, executive producer of En Garde Arts, the company behind “Basetrack Live,” said she felt it was important to document the human side of going to war, without sensationalizing the experience.

“The issues are so complex” when an ordinary person deploys, Ms. Hamburger said. Her biggest challenge for the production, which is showing at the Harvey Theater, Brooklyn Academy of Music, and will be going on a national tour, was paring down the “incredible wealth of material,” she said.

Ms. Hamburger reached out through Facebook, gathering more than 100 respondents and conducting three dozen interviews to cull images and video for the project. Every word in “Basetrack Live” is taken from interviews with Marines or members of their families.

This citizen journalism captures the truth of troops’ feelings during deployment, including graffiti about pornography, and profane, funny rules for standing watch and cleaning toilets. The images chosen for the production reflect the Marines’ brotherhood, including an impressive assortment of tattoos. Because of the authentic, emotion-rich material, the Marines are painted neither as heroes nor victims.

The plot delves into the relationship between Cpl. A. J. Czubai and his wife, Melissa. Corporal Czubai is played by Tyler La Marr, a former Marine Corps sergeant and the founder of the Society of Artistic Veterans. Mr. La Marr is quick to point out that his experiences as a signals intelligence analyst in Iraq were distinctly different from Corporal Czubai’s infantry deployments to Afghanistan.

Initially, Mr. La Marr was worried that Corporal Czubai would be angry “because a pogue is telling his story!” he said in an interview, referring to military slang for “a person other than grunt,” or infantryman. But talking with Corporal Czubai helped, and the actor acknowledged that his boot camp training, with its ethos of “every Marine a rifleman,” gave him a head start on the role.

Melissa Czubai, played by Ashley Bloom, wrestles with a lack of control over situations engineered by the Marine Corps, including A. J.’s inability to be present for the birth of their daughter because of his predeployment training. “Basetrack Live” also includes the perspectives of other wives and girlfriends, and that of one Marine’s mother, to illustrate the war’s toll on families.

The web of relationships also highlights the desire of civilians to hear from Marines in close-to-real-time, bringing to light the space between deployed and home environments, and the nuanced human drama that it spans. Social media’s rapid communications can be a mixed blessing, as worries on the home front can be transmitted to deployed troops, and electrons can convey flaring tempers in both directions. Of greatest concern were erroneous reports of casualties on Facebook, which only served to accelerate the rumor mill among wives and girlfriends. In Corporal Czubai’s case, his wife learned of his best friend’s death before he did, even though he was in a neighboring company in Afghanistan.

The speed of modern life, reflected in social media, can also be jarring to nerves accustomed to a contained, mission-focused environment. After being wounded in a firefight, Corporal Czubai is sent back to the United States, while his comrades carry on in Afghanistan. This loss of his unit’s camaraderie disorients him. Overwhelmed by paranoia and guilt, he drinks, buys an array of weapons, threatens suicide and struggles with a strained marriage. He eventually accepts counseling from the Department of Veterans Affairs, but the play avoids a saccharine ending.

Now out of the Marine Corps and studying for a bachelor’s degree in civil engineering at the University of Texas at Arlington, Corporal Czubai has seen several performances of “BaseTrack Live” and found the adaptation of his story “captivating.”

Ms. Hamburger said that she intended for the show to walk a fine line: conveying emotion without being overly sentimental about the participants’ experiences. The music — original compositions by Edward Bilous, Michelle DiBucci and Greg Kalember — blends a variety of styles: the rush of initial deployment to Afghanistan mixes powerful hip-hop with tribal tunes, while the disorientation of combat is illustrated by crashing rock and bright lights.

Using authentic videos and images, “Basetrack Live” offers a realistic perspective on relationships when one partner has gone to war, and how, after the long road home, social media can be a useful tool to build a sense of community. The wives and girlfriends of those serving in the First Battalion, Eighth Marines, who found each other via the project’s Facebook page, offered one another support, including tactics for waking sleeping Marines with hair-trigger reactions. And many of the Marines, themselves, stayed in touch with one another long after returning home, and were trading bear hugs at Tuesday night’s performance.

In future wars, the speed of communication will only get faster. Short of hologramming into combat, service members’ loved ones cannot get much closer than connecting daily via social media. Emotionally, this can blur the lines between battlefield and home front. “Basetrack Live” ably captures this juxtaposition and its aftermath, affording viewers a fresh look at war’s realities and at the challenges of coming home.
“Basetrack Live” was adapted by Jason Grote in collaboration with Seth Bockley and Anne Hamburger. It is playing at the Harvey Theater, Brooklyn Academy of Music, (651 Fulton St, Brooklyn) through Saturday.

Teresa Fazio was a Marine Corps officer from 2002 to 2006 and deployed to Iraq. She lives and works in New York, and is writing a memoir about a relationship during deployment.

Marines of the First Battalion, Eighth Marine Regiment responded to enemy contact in Falluja, Iraq, in November 2004.Credit Courtesy of Thomas James Brennan

On Nov. 6, 2004, NATO forces launched an assault on Falluja, a city north of Baghdad that had become a magnet for Sunni insurgent forces. Thomas Brennan, then a 19-year-old Marine Corps lance corporal, was one of the infantrymen with First Battalion, Eighth Marine Regiment who would participate in the attack. The battalion suffered numerous casualties in the battle, one of the bloodiest for American forces since Vietnam. Now a journalism student, Mr. Brennan recalls the battle with the help of some of the Marines and sailors he fought beside.

Grains of sand floated through motionless air as beams of light crept through sandbagged windows. Young men sat mesmerized by the words echoing from walls scarred by years of war.

Through cigarette smoke and desert confetti, Doug Bahrns, who was then a Marine second Lieutenant, exuded confidence and trepidation as he explained over two hours the details of our mission and what should happen when — not if — we were wounded. He paused often, gazing into the darkness above our heads. He knew he wouldn’t bring us all home.

Now a major assigned to Marine Corps Base Quantico in Virginia, Major Bahrns recalled recently the weight he felt leading Marines “into such a large-scale fight where it was inevitable someone was going to get killed.”

“Nov. 10, 2004, is one of the most significant days of my life, changing not only my life, but other’s lives,” Major Bahrns said. “It put into perspective life, death and the brotherhood within military service. That was the first day, alongside my fellow Marines, that I truly felt I’d cemented my place among them.”

Ten years ago, roughly 13,500 American, British and Iraqi forces attacked Falluja, Iraq, where roughly 4,000 insurgents fought from trenches, tunnels and houses, using improvised explosive devices, rifles, rockets and machine guns. During the 46-day battle, roughly 2,000 insurgents were killed and 1,500 captured. By Dec. 23, 107 members of coalition forces had died and 613 were wounded. Alongside Lieutenant Bahrns, in Alpha Company, First Battalion, Eighth Marine Regiment, 17 died and 102 were wounded. It was the heaviest urban combat since the 1968 Battle of Hue City during the Vietnam War.

Before Lieutenant Bahrns’s first sunset in Falluja, he screamed for a corpsman to save his good friend, First Lt. Daniel T. Malcolm. Lieutenant Malcolm loved to study military tactics as much as he loved playing chess, which to him was yet another way he could train his mind to defeat an opponent. If life were a brilliancy — a deeply strategic chess match — he made his a brevity, which is winning a chess game in 25 moves — his age when he was killed in action.

I regret playing chess with Lieutenant Malcolm only once. After four months of convoys as his driver, I struggle now that I didn’t allow myself to hurt when he died. I was never lucky enough to befriend the man I admired most.

Sgt. Billy Leo is everything I imagine a Bronx native to be – crude and opinionated with a hair trigger, once tearing my “Yankees Suck” T-shirt from my body. I can’t count how many times he pointed out my mistakes, but I cherish the times he gave me his approval.

“Falluja got the better of me once I came home. I really missed it even though it sucked,” said Mr. Leo, a 37-year-old New York City firefighter. “There isn’t one day where I don’t think about that battle.”

“It was a lot of adrenaline,” he added. “Nothing will ever give you that feeling again.”

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The helmet of a Marine from the First Battalion, Eighth Marine Regiment, bears the names of brethren killed in action during the battle of Falluja.Credit Courtesy of Thomas James Brennan

Mike Ergo, then a corporal, admired Sergeant Leo’s leadership and feared wearing Red Sox attire. November, for Mr. Ergo, is no longer a month he avoids. His daughter Adeline was born on Nov. 4, 2010, and his career providing peer support to other veterans led him to pursue a master’s degree in clinical social work.

Working as a counselor at the Department of Veterans Affairs Vet Center in Concord, Calif., has helped him “come home.” Battling guilt, loss and grief for years, Mr. Ergo credits his career with helping him overcome living with the loss of life, both American and Iraqi.

“I’d do it all again, even if I knew I wouldn’t agree with the political reasons or if I knew all of the fighting wouldn’t bring peace to the region,” said Mr. Ergo, 31. “The level of love and commitment we have for our fellow Marines means that you’ll go through hell with them not wanting to trade places with anyone.”

Fighting alongside us in First Platoon was Staff Sgt. Adam Banotai. In his squad of 17, he watched 11 Marines become casualties. His platoon earned 37 Purple Heart medals and five awards for valor.

“It petrifies me that I made a decision that was based off of my feelings and not good tactical judgment,” said Mr. Banotai. “None of what my guys say makes me stop thinking I could have pushed them harder, saved them from shedding so much blood. Those men are my heroes.”

Since Nov. 26, 2004, Reinaldo Aponte, then a petty officer third class line corpsman, has felt pained when he remembered the Marine he could not save. He was pulled away from Lance Cpl. Bradley Faircloth’s body believing he had done his best. But replaying the situation in his mind since, he still wonders: Could he have done more?

“I didn’t look at any of the Marines. I was so angry, screaming incoherently. I cried, feeling like I’d let my squad down,” said Mr. Aponte, now 31, of Milwaukee. “I was scared they wouldn’t trust me anymore. I didn’t want them to be afraid to call on me as their corpsman. I needed to remain a part of the squad. I was afraid of losing all of them because I lost Brad.”

As the chaplain for our battalion, Lt. Dennis Cox spent hours with us discussing our concerns. He tried to justify killing the enemy. He prayed for each of us. He wiped tears from our eyes. He cleaned the blood from the faces of our fallen. He too, cannot stop reliving our battle.

He is now a commander in the Chaplain Corps at Naval Station Norfolk in Virginia. “When they die, a part of you goes with them,” Commander Cox said. “We smell something, we see something, we hear something and it triggers something we were doing 10 years ago.”

Over the years, Commander Cox has stayed in touch with the families of our fallen. Just like us, he considers them family. For him, it’s a painful reminder of how much they lost.

Kathleen Faircloth knew what to expect. Her son, Bradley, was wounded twice before the second battle of Falluja. Marines standing in their dress uniforms at her front door meant only one thing. For 10 years, she hasn’t showed anger toward our platoon. Instead, she is glad we remember her son. As long as his memory is alive, she said, she will find happiness.

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Lance Cpl. Bradley Faircloth in Falluja, Iraq, in November 2004.Credit Courtesy of Thomas James Brennan

“I lost a son, but I gained children across the country. I know that if I ever needed anything, they would do anything they could to help me,” said Ms. Faircloth, now 50, of Fairhope, Ala. “I hope they find peace in their heart, because seeing them miserable isn’t how I want to see them.”

Whether still in uniform or having moved on to a different chapter of our lives, remembering is something we can’t fail to do. While some have a memorial in Massachusetts, Alabama or at The Citadel, some veterans of Falluja remember each of their fallen brethren through writing, by advocating for the Iraqi families we displaced, or by displaying the noble and true face of our generation.

In the last 10 years, we’ve lost sons, brothers, wives and children, struggling to maintain our own sanity and even after many failed attempts, we continue helping one another from becoming part of the suicide epidemic. Some of us, much like in Falluja, are still bounding house-to-house, searching for something we left behind and a way to evade what we brought home.

Thomas James Brennan is studying investigative journalism at Columbia University’s Graduate School of Journalism. Before being medically retired in 2012, he was a sergeant in the Marine Corps who served in Iraq and Afghanistan with the First Battalion, Eighth Marines. He is a member of the Military Order of the Purple Heart and the recipient of a 2013 Dart Center honorable mention and the 2014 American Legion Fourth Estate Award. Follow him on Twitter: @thomasjbrennan

Joseph Gotesman, right, and other VetConnect workers made rounds in the Hunts Point section of the Bronx in May.Credit Ozier Muhammad/The New York Times

Under the tracks of a northbound 5 train, Joseph Gotesman pulled a sandwich from a plastic bag and approached a man sitting near a jumble of boxes. His query was crisp and succinct: “Excuse me, sir. Are you a veteran?”

Mr. Gotesman, 22, leads VetConnect, a Bronx-based organization devised to combat homelessness among veterans. Since it started work in January, the small group has made contact with dozens of veterans living on the streets in and around the Bronx. VetConnect has helped five veterans get permanent housing, including one who needed it to get much-needed surgery, and has worked with others to find employment.

“Many of our partners started out as small, neighborhood-focused organizations. We value every effort, however small, to reach out to a homeless man or woman and connect them to services,” Chris Miller, the spokesman. “It makes a difference.”

The strength of VetConnect, said Mr. Gotesman, is its grass-roots nature. “We’re local,” he said. “You can’t get more local than community members reaching out to their own. And as we grow, it will be community members reaching out to their own as well. You won’t see me at a VetConnect excursion in an L.A. or a Boston community excursion.”

And that is exactly where the organization is heading. In the last few months, VetConnect has begun the process of putting together teams in other states where homelessness among veterans is high, such as California and Texas. In September, VetConnect was awarded a $5,000 grant from the Arnold P. Gold Foundation, which will assist the organization in, among other things, expanding, conducting research and distributing materials.

But Mr. Gotesman, who is in his second year of medical school at Einstein College of Medicine in the Bronx, has found that the issues that homeless veterans face are complex and often require continuous effort to resolve.

“Helping a veteran is not a quick, simple feat,” he said in an email. “It takes time and relationship and trust building.”

Still, fostering relationships with veterans living on the streets can be difficult. Mr. Gotesman says that many of the veterans he has met are wary of seeking help from the Department of Veterans Affairs.

“Many do not believe the change is possible,” Mr. Gotesman explained. “After years or decades on the streets, begging for handouts from passers-by, it almost seems too good to be true.”

Joseph Mangione, 56, was begging for money under the Brooklyn Bridge when he met Mr. Gotesman last December. “It was snowing,” Mr. Mangione recalled in a phone interview. “I was holding a cardboard sign that said ‘homeless veteran.’ He pulled over and offered me help.”

Mr. Gotesman checked on Mr. Mangione every two weeks after their initial encounter. Meanwhile, he and other volunteers called the local V.A. hospital and began the process of verifying Mr. Mangione’s service record and his eligibility for benefits. With help from VetConnect and Section 8 vouchers from the United States Department of Housing and Urban Development, Mr. Mangione was able to move into his own apartment in the Bronx just three months after he met Mr. Gotesman. He recently was granted a license for street vending, allowing him to earn an income and begin to sustain his newfound life.

Mr. Mangione, who served as an infantryman in the Army during the Persian Gulf war of 1991, said he avoided going into shelters when he became homeless.

“They want to throw you in these shelters with drug addicts and alcoholics,” he said. “A soldier doesn’t want to live around that.”

He was also critical of the Department of Veterans Affairs. “They wanted me to jump through so many hoops,” he said.

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Joseph Mangione, who served as an infantryman in the Army during the Persian Gulf war of 1991, in his apartment in the Bronx.Credit Courtesy of Joseph Gotesman

Mr. Gotesman said VetConnect’s goal for veterans was not “to ‘give them a fish,’ it’s to ‘teach them to fish.’ That is, to motivate them to a change and then provide them the necessary connections and resources to achieve their success.”

Recently, Mr. Gotesman helped a veteran named Lawyer Anderson get surgery that had been delayed because he was in and out of shelters, where he often had to sleep in a chair when beds were full. Mr. Gotesman said the Department of Veterans Affairs would not operate on Mr. Anderson’s service-connected injuries until he was in a stable home. After months of trying, VetConnect was able to get him permanent housing and the surgery he required.

Dr. Michael J. Reichgott, who served as an officer in the Army Medical Corps during the Vietnam War, is a professor of internal medicine at Einstein and Mr. Gotesman’s faculty adviser. Dr. Reichgott believes that VetConnect’s small size could allow it to be more personal than larger veterans groups, and called Mr. Gotesman’s efforts “a commendable effort at community service and social advocacy.”

Questions remain about whether such small organizations can address a population of homeless veterans that, according to some estimates, makes up a quarter of the homeless in New York City. But for veterans like Mr. Mangione, VetConnect is a clear answer to a complex problem.

“There should be more like it,” he said. “It’s a shame there’s not.”
Jacob W. Sotak served in the United States Army Reserve for 10 years, including a tour in Afghanistan. He graduated from Dartmouth College and now works as a news assistant at The New York Times. Follow him on Twitter: @JWSotak

As bow-tied waiters cleared plates and emptied coffee cups inside a plush meeting room at the Yale Club in Midtown Manhattan earlier this month, about 30 veterans from nearby community colleges listened to representatives from Yale, Dartmouth, Wesleyan and Vassar describe their veterans programs and answer questions about academics, financial aid and housing.

Rob Cuthbert, an enlisted Army veteran and member of the fiduciary board of the Yale Veterans Association who helped to organize the event, said the session was an attempt to address a phenomenon he referred to as an “exigent crisis”: the small numbers of veterans attending elite four-year colleges and universities.

“Numbers from the Department of Labor suggest that there are at least 1.4 million veterans without bachelor’s degrees,” Mr. Cuthbert said in a phone interview. “A bachelor’s degree is a key tool for socioeconomic mobility in today’s economy. Enlisted veterans should not doubt that there are clear pathways to Ivy League and peer schools.”

According to school administrators, there was one undergraduate veteran attending Princeton during the 2013-14 academic year, out of 5,244 undergraduates. Harvard had four among its roughly 6,700 undergraduates. Brown had 11 out of 6,182. Dartmouth, whose former president, James Wright, is an enlisted Marine Corps veteran who encourages veterans to continue their education during his visits to military hospitals, had 18 of 4,276.

Data from the Department of Veterans Affairs also shows that less than one half of one percent of the Post-9/11 G.I. Bill money paid since 2009 has gone to individuals attending Ivy League schools. Of that relatively small amount, an even smaller portion went to enlisted veterans attending undergraduate programs at those colleges. The remainder went to dependents of service members, officers or enlisted veterans attending graduate programs.

In response to those numbers, organizations like the Posse Foundation have turned their attention to bringing more veterans to the nation’s colleges. The foundation was started in 1989 to help underrepresented students to enter top-tier schools. Two years ago, Catharine Bond Hill, the president of Vassar College, began working with the group to apply their model — which focuses on helping exceptional community college students gain admission to elite four-year colleges — to veterans.

The Posse Foundation mandates that every member of a class attend a monthlong training seminar designed to prepare them for the rigors of full-time scholarship and to promote camaraderie among the members. Additionally, members must begin as first-year students, regardless of how many community college credits they have accrued.

As of this year, Vassar has successfully matriculated two veteran cohorts, bringing the number of veterans at Vassar to 21, out of 2,450 undergraduates. The hope is to continue to admit one group of veterans every year, which would mean, in two years, veterans would constitute nearly 1.5 percent of the student body, should overall enrollment remain the same.

“One of the things we have been trying to do over the last decade or so is create a diverse student body,” Ms. Hill said. “This effort is part of creating that diversity.”

This year, Wesleyan University followed Vassar’s lead and admitted 10 veterans to its freshman class under the Posse program.

“The goal,” Ms. Hill said, “is to get 10 to 12 schools in the program. With the current three cohorts in place, we will be able to converse with other schools about how they might make this program work for them.”

But matriculating veterans is a complex operation. Most four-year colleges cater to students between the ages of 18 and 22. Student veterans, on the other hand, tend to be older, are sometimes married or have children, and can present challenges different to those of a typical undergraduate student.

Dan MacDonald, 50, a freshman at Dartmouth, is married and has a 10-year-old daughter. Though he was able to secure off-campus housing with help from faculty members, he will attend the first term alone, leaving his family behind on Long Island.

“I’ll be there for 10 weeks and then back for six,” he said. “It’s almost like I’m deploying.”

For some veterans, the deferment of their education has increased their desire to complete it rapidly, which can undermine a traditional four-year liberal arts experience.

“I found it to be a struggle because I already had a different mind-set about going back to school,” said Chadelle Sappa, 24, who began taking classes at Georgia Regents University after five years in the Army. “I wanted to get it done as quickly as possible. I had already delayed my education so much that all I wanted was to get out and get a good job.”

Ms. Sappa said she felt alienated from her fellow classmates and that she considered dropping out after one semester.

“There was no community,” she said. “And the lack of a social network affected how well I did in school. After that semester, I thought about deploying again.”

But instead, Ms. Sappa attended a rigorous academic workshop at Yale University run by the Warrior-Scholar Project, an organization that helps veterans transition from the military into college. Ms. Sappa said that the experience helped her refocus on school and return to college with confidence. She is now a second-semester freshman at Georgia Regents and is considering applying to Yale.

Carl Callender, a member of the first veteran cohort at Vassar, was working full time and attending classes at Bronx Community College when he learned about Vassar’s initiative.

“My plan was, at the time, to get my associate’s degree and then transfer to Hunter or Baruch,” he said, referring to two campuses of the City University of New York. “I was at a point where I felt that certain opportunities were no longer available to me. But then along came Posse.”

Mr. Callender, who served in the Marine Corps Reserve for eight years, said that the transition to campus life was hard, but greatly eased by the presence of a group of veterans.

“I stuck out like a sore thumb,” Mr. Callender, 35, said of his first day on campus. But his fellow veterans provided social support. “I had people I knew, people I could eat with and people I could study with.”

Even so, returning to school had been a somewhat disorienting, if positive, experience.

“It’s awkward coming here,” he said of Vassar, where he is a sophomore. “It’s almost like someone hit the reset button. Five years ago I would have been able to tell you exactly what I wanted to do. But now, I am like a kid in a candy store.”
Jacob W. Sotak served in the United States Army Reserve for 10 years, including a tour in Afghanistan. He graduated from Dartmouth College and now works as a news assistant at The New York Times. Follow him on Twitter: @JWSotak

It was dark. Iraq. The middle of the night. The height of the insurgency. The explosion shook our insides. I ran up to my friend and looked at what was left of his body. His limbs were blown off. His eyes were still open but he stared off into nothingness. He gasped and choked as his body was still trying to breathe. I did everything I could to save him, but he still died in my arms.

This is what I brought home from the war with me, and it almost killed me. Or, I should say: This, and many similar incidents like this from my deployment, is why I almost killed myself when I returned home.

I was just a boy when I joined my country’s military. Eighteen years old. I was untested and unproven and I thought that joining a Special Operations unit and fighting in a war was the only way to prove my love of country, and my self-worth. But I learned an extremely hard and valuable lesson: War is not glorious. There are no monologues. There are no curtain calls where everyone joins hands on stage and bows to the audience at the end.

It is messy. It is violent. It makes you hate your enemy, even long after the war is over. It brings out the worst in people.

It brings out the worst in you.

Or at least, so I once believed. For the last six years, I felt an honor and pride in the hardships I had faced. But I also felt a hate and mistrust for the Iraqi people I had fought, and tried to protect. And I still harbored those feelings right up until one recent morning. Right up until brunch time, when my son’s kindergarten class decided to have a “Teddy Bear Picnic.” An event that would teach me a sobering and humbling life lesson.

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Gerardo Mena and his son.Credit Courtesy of Gerardo Mena

I was busy unrolling and perfectly placing my son’s Spider-Man blanket that we made from a No-Sew kit last year, when I saw them preparing their own blanket a few feet from us. Arabs. I could feel my stomach muscles clench as that initial wave of hate began crashing itself against my insides. That uncontrollable spider sense that lingered from the war. The one I couldn’t seem to turn off. The one that kept me safe, vigilant and hateful.

I seated myself on our blanket with my back to them, not wanting the image of them to spoil my day off and ruin my precious time with my son, the way they spoiled my mid-twenties.

Three bites into my bologna sandwich and I decided I didn’t want my back to them because it made me nervous. Always vigilant, I told myself. So my son and I boot-scooted around so I could place my beady, mistrustful eyes on them. Then they surprised me.

These weren’t the typical extremist types. They couldn’t be. They looked amazing. This Arab man, late twenties (still fighting age) had a short beard. One could argue an Americanized or Western-style facial hair that is popular right now in Hollywood (Ryan Gosling, anybody?). He had on a tan argyle sweater, black jeans and beige loafers. He was quite stylish, and a far cry from sporting a suicide bomber’s vest. His wife had on a colorful dress full of pink, white and brown Rorschach stripes with a matching hijab, and she radiated a warmth and beauty and kindness that I’ve never seen in an Arab (Iraqi or otherwise). And then there were their two twin daughters who were absolutely adorable in their jumpers and their dark hair done up in matching pink bows. This family looked like they were taken straight out of a magazine.

They looked more respectable and modern than my slightly-dirty-yet-still-smells-clean-enough Old Navy pullover, broken-in blue jeans, tired-looking eyes, and brown sandals with random threads hanging out of the stitching.

It was then that the two kindergarten girls called out to my son, said hi, and waved to him with matching piano-like grins. My son turned around and returned the sentiment and went back to eating his bologna sandwich.

Then, another boy two feet away with a mop full of bright red hair and a face full of freckles said hi to my boy. He, again, returned the sentiment and went back to eating his sandwich. Then, an African-American boy said hi. My boy, again, returned the sentiment. Then, my boy initiated his own greeting and said hi to an awkwardly tall Caucasian girl two blankets away. And before I knew it, my boy had greeted, or had been greeted by, all 22 kids in his class, no matter their race or religion or age. It was beautiful to watch.

The teacher called for the students to line back up to go inside. I looked over and the Arab couple had turned their backs to me.

I stood up and brushed the grass off my legs and peered over their shoulders. I saw both of them braiding their daughters’ hair, putting their pink bows back in place and then hugging their children as lovingly as I hugged my own son. Then the twins ran over and grabbed my boy by the hand and they skipped over to the lineup area together.

I realized I wasn’t some hardened ex-war hero fighting machine. I was just a racist jerk. And all it took was a lunch period with a class full of 6-year-olds to show me that America was still the greatest country in the world and that there was still hope for me to become a better man. A real man.
Gerardo Mena, a decorated veteran of the war in Iraq, spent six years with the Reconnaissance Marines. He is the author of the war poetry collection, “The Shape of Our Faces No Longer Matters.” For more information go to www.gerardomena.com

“In the Army there are those who walk the walk, and those who just talk the talk.” My drill sergeant at Fort Knox said this to me more than 30 years ago. What he was implying was that there are jobs for soldiers, and jobs for people who just joined the Army for the college plan or to get some skills training.

I had a couple walking-the-walk jobs when I was a young soldier. But for most of my career, the last 17 years of it, I was a military intelligence guy — a case officer — someone who tried to recruit other people to commit espionage; people think of us as spies not warriors. Probably no one ever joined the Army dreaming of being a case officer. Not walking the walk.

And for half of my career, I was a reservist; people think of us as serving one weekend a month and two weeks during the summer. Not walking the walk. While I was in the reserve my civilian job was as a Foreign Service officer. Certainly not walking the walk.

In many cases, my not-walking-the-walk job consisted of going to far away places in the midst of an uprising or insurgency; coming to understand the situation, the parties, their grievances and wants; then writing home about what I had learned. I wrote crisp dry accounts of messy horrible acts of cruelty on long deployments in places like Rwanda, Kosovo, Afghanistan, Iraq, and Sudan — places I thought of as existing along the ragged edge of what my friends and family at home might consider the civilized world.

But writing those crisp dry accounts was not enough for me. Fifteen years ago, in another century, I sat down at a small desk in a rented house in Pristina, Kosovo, and wrote these words, “Yellow. Their skin was yellow.”

Writing my essay, “Yellow,” was my attempt to write the remainders, the things I remembered about the war that did not make it into the official government record. I wrote about the look on an old man’s face as he sat, wounded, in an airless room surrounded by women and children who had also been wounded in a Serbian mortar attack on their village. I wrote about being unsure whether a burned body found in a locked building was that of a child or of a dog. I wrote about a Serb thug holding his pistol against my temple while he yelled how he was going to rape my interpreter and then kill us both.

I didn’t know it at the time, but what I was really writing about was how I developed PTSD. It actually took me several years to figure that out. Years during which I continued to deploy to war zones, weakening myself and feeding the PTSD. A few years after I wrote “Yellow,” I drove out into the desert with a pistol and a couple of beers ready to kill myself.

Luckily, I was interrupted. I came home and got medical treatment. Some of which worked and some of which did not really help. Writing seemed to help, so I kept at it. In time, I had a book. It’s called “Seriously Not All Right: Five Wars in Ten Years.”

A couple of weeks ago, one of the editors of “At War,” asked me to write something about the book, why I wrote it, and what I learned from the process.

Why I wrote the book is simple: I wrote it because that is how I got control of my life and overcame the traumatic memories of five wars in ten years.

Why I published it is a better story, though. While I was writing about the lives I saw destroyed in five wars over 10 years, I looked a little closer to home and started writing about the stigma in the military and in the civilian world, too, of asking for help for PTSD. I wrote about how ridiculous it is that we compartmentalize mental health care from other health care—it is all just health care, after all.

But I was just talking the talk and that is not good enough. It’s analogous to slapping one of those “I support the troops” yellow ribbon magnets on my SUV while I’m on my way to the mall. If I was going to complain so bitterly about the stigma of asking for help, and do so with any authority or integrity, I had to say it out loud. I had to walk the walk.

So I went public with my story. I admitted I had PTSD. I admitted I had come close to suicide. I did so in the hope that someone else might feel safe to do the same.

Once I had come out, I was surprised that most people just sort of shrugged and moved on. A few close friends and colleagues said, “Oh, I never knew.” But in general, there was no trauma about coming out. I don’t really know what all I had expected, but I expected something different. I kind of thought I might get a human stain like that mark on Gorbachev’s head. Maybe I’d be forced to wear a big “L” for loony on my jacket. But no, not so much.

I’ve been out on book tour for a few weeks, off and on, reading and taking questions, sitting for interviews, answering lots of emailed interview questions. My publisher and publicist decided to spread out the tour over a period of months. They were doing me a favor. I can’t tell this story every day for days on end. It’s still hard to talk about taking a pistol in my hand out in the desert ready to kill myself. But every time I tell it I hope someone listening grows a little stronger, a little more willing to stand up and ask for help. Every time they do, they are walking the walk.

Ron Capps is the founder and director of the Veterans Writing Project, a nonprofit that provides no-cost writing workshops for veterans and their families. He served for 25 years in the Army and Army Reserve and is a retired Foreign Service officer. Mr. Capp’s memoir, “Seriously Not All Right: Five Wars in Ten Years,” was published in May 2014 by Schaffner Press.

Anthony and Ivonne Thompson at the bar where Anthony proposed in November 2006.Credit

For Ivonne Thompson, 36, pulling her husband from his wheelchair to bathe him is a way to find time for their marriage. “It is the only intimacy we have left,” she says.

Her husband, Anthony Thompson, 32, survived an explosion of an improvised explosive device, or I.E.D., while he was serving as a Navy corpsman in Iraq. He was left with a diffuse axonal injury — a severe form of traumatic brain injury — and is paralyzed, unable to communicate verbally or physically.

The care Ms. Thompson provides has become an “everyday kind of routine,” she says. After she takes their 6-year-old son, Anthony Jr., to school, she sets to Anthony Sr.’s daily care: range-of-motion exercises for his arms and legs, chest percussions for his breathing. When he has appointments, she drives him to the Veterans Affairs hospital. When there are questions about his care, she discusses options with his doctors.

“After all that,” Ms. Thompson says, “I become the wife.”

The faces of military caregivers — the spouses, the loved ones, the family members and best friends who care for the wounded survivors of war — have long been just out of view, out-of-focus entries on the gray page of veterans’ issues. But a study conducted by the RAND Corporation in conjunction with the Elizabeth Dole Foundation, released in March, has brought into sharp relief the reality of the 5.5 million military caregivers nationwide, one-fifth of whom provide care to veterans of the wars in Iraq and Afghanistan.

Over all, caregivers today are younger than those of previous generations, have fewer support networks and are at a much higher risk for depression and suicide.

For people like Ms. Thompson, caregiving is a full-time commitment to ensuring quality of life for veterans who need help bathing, feeding and administering medications. For others, supporting their loved ones is less hands-on, but no less challenging.

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Natalie Tarte with her husband, Chris Tarte, at a medical facility in November 2011.Credit

Natalie Tarte’s focus is maintaining a stable home environment for her husband, Chris Tarte, and their three young children. Mr. Tarte lost his right foot in an I.E.D. attack in Afghanistan. When doctors said his left leg, which was also mangled in the explosion, could be salvaged, the Tartes were hopeful. But after more than a dozen surgeries and nearly a year in a specialized halo cast called a Taylor Spatial Frame, doctors say the chance of saving the leg is low.

Mr. Tarte also has post-traumatic stress disorder and a form of traumatic brain injury that induces seizures. He has problems with his memory. He sometimes becomes disoriented and frustrated.

According to the RAND Corporation study, caregivers of post-9/11 veterans provide care for emotional and behavioral challenges more often than caregivers from previous wars did, and are four times more likely than non-caregivers to battle depression.

“Chris’s outbursts can be hurtful,” said Ms. Tarte, who has been placed on antidepressants. “It’s hard being married to someone that you basically don’t know. Sometimes there is just a feeling of hopelessness.”

One of the study’s more alarming findings was that more than 37 percent of post-9/11 caregivers reported difficulties because of uncertainty about their loved ones’ conditions and the treatments they were receiving. That number was twice that of pre-9/11 caregivers.

According to Rajeev Ramchand, the study’s co-leader and a senior behavioral scientist at RAND, many military caregivers have no formal support network. “There is a particular need for programs that focus on the younger caregivers who aid the newest veterans,” Mr. Ramchand said.

Emery Popoloski, 27, is one of those young caregivers, providing care for her husband, Charlie Popoloski, 29, who has debilitating seizures and severe post-traumatic stress from a rocket attack he survived while on his first tour to Iraq. The seizures, though often short, prevent Mr. Popoloski from performing involved tasks such as cooking or driving, and make supervision necessary.

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Charlie and Emery Popoloski were reunited at Logan Airport in Boston in January 2009, after eight months apart.Credit

“I feel like you’re a parent watching a kid at a playground,” Ms. Popoloski says of her husband. “You let them go play, but you’re always watching.”

Ms. Popoloski quit her job in September to stay at home with her husband and their two daughters: Caitlin, 3, and Elizabeth, 4 months. But as her husband’s sole caregiver, she has concerns about the future.

“What would happen if I died?” she asked. “What would happen to my kids if something happened to me? What would happen to my husband’s care?”

In 2010, Congress passed the Caregivers and Veterans Omnibus Health Services Act, allowing the Veterans Affairs Department to offer financial support and other services to military caregivers. The support, which includes a monthly stipend, mental health services and counseling, and access to health insurance, is available to those caring for veterans suffering from serious injuries — including traumatic brain injury, psychological trauma and other mental disorders — incurred in the line of duty on or after Sept. 11, 2001.

Though the RAND study is largely an overview of contemporary military caregivers, it raises tough questions about the future of veterans’ care and the health and wellbeing of those yoked with administering it. These are questions that — according to former Senator Elizabeth Dole, Republican of North Carolina, whose foundation commissioned the study — point to the future and confirm that military caregiving is an “urgent societal crisis.”

The report offers several recommendations, including creating programs to foster caregiving skills and approaches and conducting research into caregiving and caregivers to help ensure continued attention to their needs.

For many caregivers, a brighter future is all they can hope for.

“You need to keep moving forward,” Ms. Popoloski says. “You’re going to die if you stay in the same place.”

Jacob W. Sotak served in the United States Army Reserve for 10 years, including a tour in Afghanistan. He graduated from Dartmouth College and now works as a news assistant at The New York Times. Follow him on Twitter: @JWSotak

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At War is a reported blog from Afghanistan, Pakistan, Iraq and other conflicts in the post-9/11 era. The New York Times's award-winning team provides insight — and answers questions — about combatants on the faultlines, and civilians caught in the middle.

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